title: Therapeutic options to enhance coma arousal after traumatic brain injury: state of the art of current treatments to improve coma recovery.
abstract: Traumatic brain injury is a leading cause of death and disability. Optimizing the recovery from coma is a priority in seeking to improve patients' functional outcomes. Standards of care have not been established: pharmacological interventions, right median nerve and sensory stimulation, dorsal column stimulation (DCS), deep brain stimulation, transcranial magnetic stimulation, hyperbaric oxygen therapy and cell transplantation have all been utilized with contrasting results. The aim of this review is to clarify the indications for the various techniques and to guide the clinical practice towards an earlier coma arousal. A systematic bibliographic search was undertaken using the principal search engines (Pubmed, Embase, Ovid and Cochrane databases) to locate the most pertinent studies. Traumatic injury is a highly individualized process, and subsequent impairments are dependent on multiple factors: this heterogeneity influences and determines therapeutic responses to the various interventions.
authors.affiliation: Azienda Ospedaliera Universitaria San Luigi Gonzaga , Orbassano, Turin , Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cossu
mesh_terms: D000547:Amantadine / Q000627:therapeutic use; D001143:Arousal; D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation / Q000628:therapy*; D017690:Cell Transplantation; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003128:Coma / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy*; D046690:Deep Brain Stimulation; D015259:Dopamine Agents / Q000627:therapeutic use; D004358:Drug Therapy; D004599:Electric Stimulation Therapy; D015600:Glasgow Coma Scale; D006801:Humans; D006931:Hyperbaric Oxygenation; D008475:Median Nerve / Q000502:physiology; D008774:Methylphenidate / Q000627:therapeutic use; D020127:Recovery of Function; D013116:Spinal Cord / Q000502:physiology; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D015259:Dopamine Agents; D008774:Methylphenidate; D000547:Amantadine